Feeding cues

Your baby has to wake up and let you know that he or she wants to eat. This is called showing feeding cues. A baby should show they are hungry 8 to 12 times in a 24-hour period. Watch your baby and begin breastfeeding when you see your baby:

Licking

Making sucking movements

Rooting

Bobbing the head against the mattress or your neck or shoulder

Bringing hands to face or mouth

Squawking

Crying is a late feeding cue. Many babies have problems latching on once they become frustrated and begin to cry. Try to feed your baby before he or she cries. If your baby does cry and can't latch on, calm your baby before trying again. Put your baby skin-to-skin away from the breast or let him or her suck on your finger. Or have someone else hold the baby for a while so your baby can calm down. Then offer to nurse again.

Feeding positions

It will be easier for your baby to latch-on if he or she is snugly and in a good position for feeding. The most common feeding positions include:

Cradle. The baby is held in the crook or elbow area of your arm on the same side as the breast to be used for feeding. You support your breast with the opposite hand. Your baby's body is rolled in toward your body so you are belly-to-belly. You should not be able to see the baby's arm that's closest to your body. And your baby's chin should not be down against his or her chest in this position.

Cross-cradle. The baby's head is supported by your hand that is opposite the breast to be used for feeding. You support your breast with your hand. The baby is rolled in toward your body belly-to-belly. As in the cradle hold, you should not be able to see the baby's arm that's closest to your body.

Football or clutch. Baby's head is supported by your hand that's on the same side as the breast to be used for feeding. Your baby's body is supported on a pillow. The baby is tucked under your arm on the same side as the breast to be used for feeding. Many women who have had a cesarean-section delivery prefer this position. It keeps pressure off your belly.

Side-lying using modified cradle. Your baby lies next to you. Your bodies are facing each other. If a pillow under your arm is uncomfortable, try placing your baby in the crook of your arm. This position also keeps the baby's head at a good angle to bring baby and breast together. The baby's head is also higher than his or her tummy. This can be helpful for babies who are more likely to spit up.

Laid-back breastfeeding. You are leaning back in a recliner or reclining in bed. Your baby is lying on his or her stomach on top of you. You can support the side of your baby's head if your baby can't hold it up. In this position, both you and your baby can relax. You can let your baby explore your breast and latch on at his or her own pace.

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For all positions, bring your baby to the breast. Don't bring your breast to the baby. Start getting in a good position before you try to latch. It can help to sit in a roomy and comfortable chair or sofa. Some women find it comfortable to use a pillow on their lap to raise the baby to the breast. Your baby must be held in good alignment if he or she is to suck, swallow, and breathe during feedings. When in good alignment, you should be able to draw a straight line down your baby's body from earlobe to hip no matter which feeding position you use. For you, being in a comfortable position means that your feet are supported, your back is supported, you are sitting up straight and not leaning over your baby, and your shoulders are relaxed. You may find it more comfortable to put a pillow under your arm or behind your back.

Deep latch-on

To help your baby get a deep latch, support your breast from below with your hand. Here are 2 holds to try:

C-hold. Place your thumb on top of your breast and your fingers under your breast, at least 1 1/2 to 2 inches behind the nipple. A C-hold gives good support for the cradle or cross-cradle feeding positions.

U-hold. This is a variation of the C-hold. It's often used when a baby is placed in the football (clutch) position for feeding. For a U-hold, slide your hand so your thumb is on one side of the breast and your fingers on the other.

You may not have to keep using a C-hold or U-hold if your breasts are smaller. But mothers with larger breasts often use these holds for the whole feeding.

Once you are both comfortable and your breast is supported, you are ready to help your baby latch. To help your baby latch-on correctly, use your nipple to stroke the baby from the nose to the lower lip in a downward motion. Wait for him or her to open wide. Then bring the baby and your breast together in one quick motion. The baby should have a big mouthful of your breast. And his or her chin and nose should be touching your breast. Your baby's lips should be flanged outward like a trumpet or fish lips. The lips should not be pursed or rolled in. If you were to roll down your baby's lower lip, you should see baby's tongue gliding in front of the lower gum. The tongue should also cup your nipple and areola.

Don't press down near the areola with your thumb. You may think this will help your baby breathe. But this will pull your nipple from the back of your baby's mouth, where it needs to be. Babies' noses are designed to press against their mother's breast as they feed. That is why their noses are flat. This lets them latch on deeply to the breast but still be able to breathe. If you are concerned about your baby's ability to breathe, pull your baby's lower body in closer to you. Or lift your breast rather than pressing down on your breast.

It is called breastfeeding, not nipple-feeding, for a reason. Sometimes a baby's latch is shallow. This means it is not deep onto the areola. The baby may seem to be hanging on the nipple tip. When this happens, your baby won't be able to remove milk from your breast very well. This would decrease the amount of milk your baby drinks. So feedings may take more than 45 minutes. And your baby may not gain weight as he or she should. Also your nipples are more likely to get very sore or cracked. Try the different positions outlined above if you are worried your baby doesn't have a deep latch. Or if you have sore or cracked nipples. If this doesn't work, contact your baby's healthcare provider or a certified lactation consultant for help.